Long Legal Fight Ahead for Obama's Health Law

Dec. 13: President Obama pauses during a statement at the White House.
(AP2010)

WASHINGTON -- The scorecard on the legal fight over President Barack Obama's health care overhaul is two judges in favor and one against.

But these are the early rounds in preliminary bouts. The one that really counts -- a showdown at the Supreme Court -- is at least a year away.

The health care law suffered its first major legal setback Monday when a federal judge declared that the heart of the sweeping legislation is unconstitutional. The decision handed Republican foes ammunition for their repeal effort next year.

The ruling by U.S. District Judge Henry E. Hudson, a Republican appointee in Richmond, Va., marked the first successful court challenge to any portion of the new law, following two earlier rulings in its favor by Democratic-appointed judges. A number of other lawsuits were dismissed early on, without rulings on the substance of the law.

The law's central requirement for nearly all Americans to carry insurance is unconstitutional, well beyond Congress' power to mandate, Hudson ruled. That put him in the same camp as Virginia Attorney General Ken Cuccinelli -- the Republican who filed the suit -- and many of the GOP lawmakers who will take control of the U.S. House in January.

But Hudson denied Virginia's request to strike down the law in its entirety or block it from being implemented while his ruling is appealed by the Obama administration.

"An individual's personal decision to purchase -- or decline to purchase -- health insurance from a private provider is beyond the historical reach of the Commerce Clause," said Hudson, a 2002 appointee of President George W. Bush.

Another judge in Florida, a GOP appointee, has not ruled in another lawsuit -- brought by 20 states against the legislation -- though he has signaled trouble for the administration. Arguments in that lawsuit, which also challenges whether the federal government can require states to expand their Medicaid programs, get under way Thursday in Florida.

Nevertheless, the White House predicted it would prevail in the Supreme Court.

"Keep in mind this is one ruling by one federal district court. We've already had two federal district courts that have ruled that this is definitely constitutional," President Barack Obama said Monday in an interview with television station WFLA in Tampa, Fla.

"You've got one judge who disagreed. That's the nature of these things."

Federal appeals courts based in Atlanta, Cincinnati and Richmond make up the next set of judges who will have their say on the law, though their rulings are at least months away.

Once appellate judges have weighed in, the next appeal is to the Supreme Court.

In April, Justice Stephen Breyer predicted an eventual high court hearing for the health care overhaul. That might not happen until after the 2012 elections, though.

In the short term, the latest court ruling hands potent ammunition to GOP opponents as they prepare to assert control in the new Congress with promises to repeal the law. Obama in turn has vowed to veto any repeal legislation and appears likely to prevail since Democrats retain control of the Senate. Republicans also have discussed trying to starve the law of funding.

Whatever the eventual outcome, Monday's ruling could create uncertainty around the administration's efforts to gradually put into effect the landmark legislation extending health coverage to more than 30 million uninsured Americans. And it can only increase the public's skepticism, which has not significantly receded in the months since the law's enactment, defying Obama's prediction that it would become more popular as Americans got to know it.

Obama aides said implementation would not be affected, noting that the individual insurance requirement and other major portions of the legislation don't take effect until 2014. Some provisions of the law took effect in September, six months after its passage, including free preventive care, an elimination of lifetime limits on coverage and requirements for insurers cover children with pre-existing health conditions and allow adult children to stay on their parents' health plans until age 26.

Hudson limited his ruling to striking down the so-called individual mandate, leaving intact other portions of the law. But administration officials and outside analysts agree that important provisions of the legislation could not go forward without the requirement for everyone to be insured. That's because insurers need to have large pools of healthy people, who are cheap to insure, or it is not financially tenable for them to extend coverage to those with pre-existing medical problems.